Constipation

OK, not your most glamorous topic. It is, however, one I get a lot of questions about.

Constipation refers to bowel movements (BM's) that are dry, pebbly looking and hard to expel. Dehydrated, in a word.

Your BM's are made of undigested plant fibers (roughage), bacteria and bile pigments. The roughage comes from fruits, vegetables and whole grains in your diet. The bacteria are a normal part of the bacterial flora in your digestive system (there are more normal bacteria on/in a human body than actual human tissue cells!). The brown color is from bile which is made by your liver, stored in your gall bladder and secreted into your small intestine to help you to dissolve and absorb essential fats in your diet.

Problem is, your colon and rectum work to re-absorb water from your bowels so you don't lose a lot of water in your BM's and become dehydrated. When your colon can't do that, it's called diarrhea.

Constipation can occur if you don't eat enough fruits and vegetables. This will mean you lack the necessary bulk to fill your rectum. Filling the rectum stretches nerve endings in it which signal your brain that you need to go to the bathroom. As this goes on, too much water gets drawn from the contents of your rectum. The end result is dry, pebbly, hard BM's. Constipation!

Please note that normal does not mean having a BM every day- it means having soft normally formed BM's.

Treatment of constipation starts with increasing dietary fiber.

1. Eat more fruits and vegetables; five servings every day would be good not only for constipation, but also in reducing many kinds of cancer.
2. Metamucil, Citrucel, bran or flax seeds taken every morning can also help and is safe.

If this is not sufficient, other medicines can be used daily and will not produce dependency on them.

1. Stool softeners such as DSS simply make your BM's softer and easier to pass.
2. Natural cathartic agents gently stimulate a BM, such as Senakot, prunes or prune juice.
   

If constipation has been going on for a long time, your rectum can become so conditioned to feel full that it can no longer signal an urge to defecate to your brain. This neurogenic bowel problem can get to the point of needing strong laxatives just to have a BM.

In such a case, you may need to do all of the above plus use Milk of Magnesia or a Dulcolax suppository every 2-3 days as needed.

Constipation with fever, abdominal pain or rectal bleeding may represent an emergency for which you should be seen as soon as possible by a doctor.

All the medicines mentioned above are easily available over the counter. Please feel free to see me about constipation. It's a very common and obnoxious problem that can be helped!